The content of this unit is about things that you should be prepared for should they be needed, but not things that you should necessarily expect to happen.
Remember that some interventions are necessary for the health of you or your baby. Some necessary things may just be as simple as having your IV fluid increased in labor or as significant as a cesarean section.
In the manual on page 43, you have already learned about external monitoring, now let's look at internal monitoring. There is a picture at the bottom of the page. (VIEW) The IUPC monitors the strength of the contractions, which is helpful to know if your contractions are adequate to change your cervix. The scalp electrode is a tiny wire that attaches to the top of the baby's head once your water is broken; it is the most accurate way to monitor your baby's heart beat. There are times when an external monitor is unable to give us a good picture of how your baby feels, in that case, an internal monitor is telling of your baby's well-being.
While in labor, it is sometimes necessary that you reposition your body, have your IV fluids increased, and maybe an oxygen mask placed over your nose and mouth in efforts to perk up a sleepy or distressed baby. Your nurse will initiate these interventions as needed.
During pushing, it may be necessary that you have some assistance. These next 3 procedures are used in vaginal assisted births: they are episiotomies, and use of the vacuum or forceps. Please go to page 48 in the manual, and read this entire page. (READ) Note the 2 reasons that these procedures are done. Realize that these things are not routine. (If these practices are routine with your provider, then you may want to consider using a different health care provider. Don't be afraid to ask him/her about his/her statistics in regards to these procedures at your next appt)
In my experience, I have seen more vacuums used than forceps, but it is your health care provider's preference. They will likely only try either forceps or a vacuum for a limited amount of time, not both. The forceps and vacuum are used simultaneously with your pushing efforts. If the vaginal delivery is unsuccessful, then a cesarean section is indicated. View the video on the vacuum. (WATCH)
**Vaginal and/or labial tearing is not uncommon. In fact 70% of first time moms will experience a minor laceration. Women tear in varying degrees. If you tear during your vaginal delivery, it will be repaired after the placenta is delivered. You will still be numb if you had an epidural, or you will be given lidocaine injections to numb you for the repair. Remember that your vagina has a great ability to heal. The stitches that they place will dissolve on their own. We learn about taking care of your perineum after delivery in another unit.
Cesarean Sections:
Let's go to Chapter 6 on the seewhatyouread.com website. View the video entitled, Cesarean Surgery. (WATCH)
The need for c-sections generally fall into 3 categories:
Planned
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Unplanned
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Emergency
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Breech baby/position of baby
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CPD, head is not fitting
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Prolapsed cord
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Placenta previa
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Abnormal fetal heart beat
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Placenta Abruption
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Medical condition- Herpes
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Labor is not progressing
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Uterine rupture
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Previous c/s
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The baby moved in an unfavorable position
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Fetal distress
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Maternal conditions or fetal condition
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Maternal condition
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Pages 50 and 51 go into greater detail why c-sections are indicated.
Please find and watch the video on Daniela's Birth in Chapter 3. (WATCH)
A cesarean birth may not be what you planned in an ideal world, but you can still have a family centered experience. Dad will be able to go back to the delivery/operating room and take pictures in most cases. You can also breastfeed in recovery as long as you and your baby and doing well. Turn to page 53 and read the entire page and yellow box. (READ)
Keep in mind that a cesarean is a major surgery, and you will need extra TLC and time to recover.
Unit 6 Assignment:
1. Are episiotomies cut routinely?
2. What are some preparation procedures that will be necessary prior to your c-section? (pg 52)
3. How long does a cesarean section take from start to finish, on average?
4. Email me to let me know you are done with Unit 6.
